PERORAL ENDOSCOPIC MYOTOMY WITH THE HYBRIDKNIFE

Aims The peroral endoscopic myotomy (POEM) is an established procedure in patients with achalasia. After incision of the mucosa the creation of the submucosal tunnel is a crucial step in this procedure. Therefor a repetive switch between injection and dissection is necessary. With standard devices the injection needle and the dissection knife has to be changed multiple times. The HybridKnife is an “all-in-one” device”, which can be used in all three steps (incision, dissection and myotomy) of the POEM procedure. We report our experience in POEM with the ERBE HybridKnife.

Methods From a database we retrospectively analysed the technical success, outcome and complications of our patients with achalasie and treatment with POEM with the HybridKnife since 2015.

Results Since 06/2015 we treated 26 patients (14 female, 12 male) with an average age of 60,5 (26-80) years. The time for the procedure was 40 to 70 min. The technical success was 100% (26/26) with a clinical success of 96% (25/26). In one patient a pleural effusion occured due to incomplete closure of the submucosal tunnel. The patient was treated successful with drainage and intraluminal stenting. In two patients a collar emphysema was noted with no need for intervention. One patient with clinical failure was treated with a second POEM successful.

Conclusions POEM with the HybridKnife is save and successful. A potential benefit could be time saving compared with standard devices.